Provider Demographics
NPI:1417345349
Name:DIRECT RX PHARMACEUTICALS, INC
Entity Type:Organization
Organization Name:DIRECT RX PHARMACEUTICALS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MR
Authorized Official - First Name:JIGNESH
Authorized Official - Middle Name:
Authorized Official - Last Name:GANDHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-250-7233
Mailing Address - Street 1:1460 MARKET ST. SUITE 316
Mailing Address - Street 2:DIRECT RX PHARMACEUTICALS, INC
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016
Mailing Address - Country:US
Mailing Address - Phone:847-250-7233
Mailing Address - Fax:888-240-7884
Practice Address - Street 1:1460 MARKET ST
Practice Address - Street 2:SUITE 316
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-4643
Practice Address - Country:US
Practice Address - Phone:847-250-7233
Practice Address - Fax:888-240-7884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid